I型IFN自身抗体是奇孔古尼亚活衰减疫苗脑炎的基础
Adrian Gervais1,2, Paul Bastard1,2,3,4, Qian Zhang1,2,3
1Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris 75015, France.
概括
自体抗体中和I型干扰素 (IFN) 引起了对奇孔古尼亚病毒 (CHIKV) 疫苗的严重反应. 患有这些自身抗体的人应避免使用活衰减疫苗,如CHIKV和黄热病病毒 (YFV).
科学领域:
- 免疫学 免疫学 免疫学
- 病毒学 病毒学
- 疫苗学 疫苗学 疫苗学
背景情况:
- I型干扰素 (IFN) 对抗病毒免疫非常重要.
- 中和I型IFN的自身抗体与严重的病毒性疾病有关.
- 奇孔古尼亚病毒 (CHIKV) 构成了日益严重的全球健康威胁.
研究的目的:
- 在老年人中调查活体减弱CHIKV疫苗 (VLA1553) 后的严重反应.
- 确定I型IFN自身抗体在疫苗相关脑炎中的作用.
- 提供关于在风险人群中接种疫苗的建议.
主要方法:
- 对5名老年患者的病例研究分析,这些老年患者在CHIKV疫苗接种后出现了严重反应.
- 检测和表征免疫球蛋白G (IgG) 对I型IFN (IFN-α和IFN-ω) 的自身抗体.
- 临床评估,包括神经状态和病毒载量.
主要成果:
- 三名患者患上脑炎,两人死亡;所有患者都有中和I型IFN自身抗体.
- 一名患者在没有脑炎的情况下幸存下来,缺乏这些自身抗体.
- 一名未接种疫苗的患者因CHIKV感染而死亡,尽管接种了疫苗,但也缺乏自身抗体.
- 在所有研究的CHIKV疫苗诱导脑炎病例中证实了对I型IFN的中和性自身抗体.
结论:
- 中和I型IFN的自身抗体是对活衰减CHIKV疫苗严重反应的关键因素.
- 具有先前存在的I型IFN自身抗体的个体有较高的不良事件风险.
- 建议对活体减弱黄热病病毒 (YFV) 和CHIKV疫苗的禁用,对于具有I型IFN自身抗体的人来说.
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